Topics in Geriatrics-Cancer and the Elderly Introduction:
Cancer affects the majority of those 65 and older. Even as such there is a lack of combining the two topics of geriatrics and oncology. This page is to provide information and references on how cancer affects the elderly and best practice in treatment of them.
Objectives:
1. To provide information on the percentage of elderly that cancer affects.
2. To provide information on the percentage of mortality in the geriatric population due to cancer.
3. To provide information on the evidence based outcome measure to use to predict the physical reactions to cancer treatment in the elderly.
4. To provide a reference for physical therapy for those 65 and older with cancer.
5. To provide references for further specialization for physical therapists that would like to focus their practice in this area. Information:
There is a lack of evidence based data on the ideal outcome measures to use on the geriatric population with regards to reaction to cancer treatment and life expectancy from those treatments. There is also a lack of combining those who specialize in oncology and those who specialize in geriatrics. Considering that cancer affects 60% of those 65 and older and is the cause of death in 70% of that population, an in depth knowledge of the subject is necessary to provide best practice to this population.
It has been suggested that there be a merging of geriatric specialists and oncology specialists into one department in order to provide best care to this group of patients. The Comprehensive Geriatric Assessment:
The health status, social support, cognitive status, comorbitities, and functional limitations all factor into how a patient will tolerate cancer treatment. The outcome measures currently used in the geriatric population are lacking in assessing all of these factors. The Comprehensive Geriatric Assessment is proposed to be a better tool for this job. This outcome measure assesses depression, pain, incontinence, fall history, BADLS/IADLS, social support, vision/hearing, medical power of attorney, level of assistance, and functional activity. Physical Therapy:
PT for the geriatric population consists of increasing strength, ROM, endurance, and functional activity capacity. The areas that are the most important are to decrease pain through massage, modalities, and PROM. Lymphatic drainage is imperative to limit edema. Cognitive activity is also significant to reduce the effects of chemotherapy on brain function. Vestibular training in habituation is helpful to reduce falls, as well balance and gait training in the use of assistive devices.
Introduction:
Cancer affects the majority of those 65 and older. Even as such there is a lack of combining the two topics of geriatrics and oncology. This page is to provide information and references on how cancer affects the elderly and best practice in treatment of them.
Objectives:
1. To provide information on the percentage of elderly that cancer affects.
2. To provide information on the percentage of mortality in the geriatric population due to cancer.
3. To provide information on the evidence based outcome measure to use to predict the physical reactions to cancer treatment in the elderly.
4. To provide a reference for physical therapy for those 65 and older with cancer.
5. To provide references for further specialization for physical therapists that would like to focus their practice in this area.
Information:
There is a lack of evidence based data on the ideal outcome measures to use on the geriatric population with regards to reaction to cancer treatment and life expectancy from those treatments. There is also a lack of combining those who specialize in oncology and those who specialize in geriatrics. Considering that cancer affects 60% of those 65 and older and is the cause of death in 70% of that population, an in depth knowledge of the subject is necessary to provide best practice to this population.
It has been suggested that there be a merging of geriatric specialists and oncology specialists into one department in order to provide best care to this group of patients.
The Comprehensive Geriatric Assessment:
The health status, social support, cognitive status, comorbitities, and functional limitations all factor into how a patient will tolerate cancer treatment. The outcome measures currently used in the geriatric population are lacking in assessing all of these factors. The Comprehensive Geriatric Assessment is proposed to be a better tool for this job. This outcome measure assesses depression, pain, incontinence, fall history, BADLS/IADLS, social support, vision/hearing, medical power of attorney, level of assistance, and functional activity.
Physical Therapy:
PT for the geriatric population consists of increasing strength, ROM, endurance, and functional activity capacity. The areas that are the most important are to decrease pain through massage, modalities, and PROM. Lymphatic drainage is imperative to limit edema. Cognitive activity is also significant to reduce the effects of chemotherapy on brain function. Vestibular training in habituation is helpful to reduce falls, as well balance and gait training in the use of assistive devices.
Links for further specialization and understanding:
1. http://www.abpts.org/Certification/Oncology/
2. http://www.abpts.org/Certification/Geriatrics/
3. https://www.uptodate.com/contents/comprehensive-geriatric-assessment
4. https://www.journals.elsevier.com/journal-of-geriatric-oncology/recent-articles
5. http://www.apta.org/Sections/
6. https://www.omicsonline.org/scholarly/geriatric-physical-therapy-exercises-journals-articles-ppts-list.php
References:
1. https://academic.oup.com/annonc/article/23/3/801/227503/Bringing-geriatrics-into-oncology-or-also-oncology/
2. http://www.sciencedirect.com/science/article/pii/S1040842805001253
3. http://www.ascopost.com/issues/may-25-2016/the-role-of-occupational-and-physical-therapy-in-geriatric-oncology/
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3738437/
5.http://journals.lww.com/topicsingeriatricrehabilitation/Fulltext/2011/07000/Foreword__Oncology_Physical_Therapy_Practice.1.aspx